Healthcare Provider Details

I. General information

NPI: 1992876767
Provider Name (Legal Business Name): COMMUNITY MEMORIAL HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1306 MARICOPA HWY
OJAI CA
93023-3131
US

IV. Provider business mailing address

147 N BRENT ST
VENTURA CA
93003-2809
US

V. Phone/Fax

Practice location:
  • Phone: 805-646-1401
  • Fax:
Mailing address:
  • Phone: 805-652-5011
  • Fax: 805-585-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL ZDEBLICK
Title or Position: PRESIDENT & CEO
Credential:
Phone: 805-652-5001